Enhancing Ego Integrity among Golden Agers - key For Nurses
Deepika T
Nursing Tutor, M.A.Chidambaram College of Nursing, Chennai
*Corresponding Author E-mail:
ABSTRACT:
Aging is a natural process which brings a number of changes in the physical, psychological, social, and hormonal conditions. When the person gets older they get involved in different life challenging phases. Once they get ill or when they go down a spiral of negative emotions, it’s the nurse’s role to enhance the ego integrity by uplifting the negative emotions of elderly. The nurses who work in department of mental health and community setting are responsible for enhancing ego integrity among elderly persons.
KEYWORDS Golden Ager, Ego Integrity
INTRODUCTION:
“The ultimate aim of the ego is not to see something, but to be something.” –
Muhammad Iqbal
As people get older, their bodies start to wear out and they begin to experience more health problems. Because of this elderly people often need more medical care than others. Mental health problems in elderly people are increasingly being recognized as a major heath issue. Dementia, memory problems and depression are more commonly seen in elderly. Increased life expectancy in recent years has resulted in growing demand for elderly psychiatry services.
Erikson (1963) studied the influence of social processes on the development of personality. He described eight stages of life cycle. In eighth stage of life (Ego integrity vs. despair) between the age of 65 years and death, the goal of every individual is to review their past life and acquire meaning from both positive and negative events, while achieving a positive sense of self. [1]
A report released by the United Nations Population Fund and Help Age India suggests that India had 90 million elderly persons in 2011, with the number expected to grow to 173 million by 2026. Of the 90 million seniors, 30 million are living alone, and 90% work for livelihood.[2]
According to census 2001, older people were 7.7% of the total population, which increased to 8.14% in census 2011. The projections for population over 60 years in next four censuses are: 133.32 million (2021), 178.59 (2031), 236.01 million (2041) and 300.96 million (2051). The increases in the elderly population are the result of changing fertility and mortality regimes over the last 40-50 years.[3]
A comprehensive status report on older persons was published in the 60th round of National Sample Survey. According to this survey, the incidence of diseases and hospitalizationwere much higher in older people than the total population. It was also reported that about 8% of older Indians were confined to their bed or home. After the age of 80 years the proportion of such home bound people rose with age to 27%. The survey revealed that 55-63% of people with a sickness were in good or fair condition of health and 77-78% of people without sickness. In contrast about 13-17% of the survey population without any sickness reported ill-health. It is possible that many older people take ill health as a part of usual and normal ageing process.[4]
Since the human life expectancy has increased and the Baby Boomer generation have started aging, the demand for geriatric nurses is expected to increase dramatically. It is also the responsibility of nurses working in department of mental health and community settings to care for the elderly persons who are facing non-achievement of ego integrity in there day to day life.
MEANING OF EGO INTEGITY:
Ego integrity is the term given by Erik Erikson to the last stage of his eight stages of psychosocial development, and used by him to represent “a post-narcissistic love which is an excessive preoccupation with admiration of oneself or the human ego”.[5]
AIM
To assist and support elderly people, physically and psychologically to achieve ego integrity.
Achievements and Non-Achievements of Ego Integrity
Achievements:
· Feels complete or whole.
· Satisfied with achievements.
· A sense of self-acceptance and self-worth.
· Accepting that some were achieved and some were not.
· A sense of dignity from his or her life experiences.
· High self-esteem and high self-efficacy.
· Self-confidence.
· Not having fear of death.
· Inclusion.
· Feels protected and self-respect.
Non-achievements:
· Failing health
· Feels worthless and helpless
· Anger
· Depression (loneliness/isolation, ideas of suicide, fear of death, thinking about past failures, etc.)
· Loss of control
· Low self esteem
Nursing Activities on Elderly People With Non-Achievement of Ego Integrity
Failing Health:
· The nurses should address on preventive measures regarding the disease that affect or likely to affect the communities in a particular geographical region.
· The nurse should provide effective care and support elderly who is suffering from various diseases through primary, secondary, and tertiary health care systems.
· Address the elderly about the cost of treatment so that no person refuses necessary health care for financial reasons.
· Health educate elderly regarding rehabilitation, community and home based disability support.
FEELING WORTHLESS AND USELESS:
· The nurse should advice the elderly person to identify the sources of feeling in order to explore it and try to find out the bothering problems.
· Advise them to find their passion to make them happy and to contribute those skills to the external world.
· Advise them to focus on their positive practice in order to overcome the useless or worthless feelings.
· Advise them to accept compliments from others.
· Tell them not to procrastinate their day to day works.
ANGER:
Ten steps nurses should teach the elderly persons to manage anger:
1. Recognize (Anger is a problem)
2. Monitor the anger level.
3. Look for a pattern (Be aware of different triggers, e.g. Bad traffic)
4. Take a time-out
5. Challenge perceptions and thoughts that increases anger.
6. Dig deeper (To understand root causes of anger)
7. Change the message.
8. Use exposure and relaxation.
9. Use humor.
10. Listen to your emotional news.
DEPRESSION:
· Identify the level of suicidal precautions needed.
· Contact the family members and arrange for crisis counseling.
· Encourage elderly to express feelings.
· If hospitalized, follow up unit protocols.
· Provide activities that require minimal concentration.
· Involve them in gross motor activity.
· Engageelderly in group activities.
· Eventually maximize the elderly’s contact with others.
· Advise them to maintain good personal hygiene like regular bathing, brushing and dressing.
Loss of Control:
· Educate and give awareness to prevent a negative feeling to inevitable loss of control.
· When feeling is severe, advise the individual and their families to deal together.
· Monitor the elderly to use their skills in order to gain respect and appreciation.
Low Self-Esteem:
· Teach visualization techniques that can help the elderly to replace negative self-images with more positive images and thoughts.
· Encourage them to participate in group therapy.
· Provide assertive training through community based programs.
· Improve their problem-solving skills.
BOREDOM:
· The nurse should identify the skills and motivate the elderly to engage in that.
· Encourage and train them to carry out productive activities that would be useful to them, their families and communities.
· Provide recreational activities to keep them occupied.
CONCLUSION:
Elderly people in their end days when they lose their independence and become more dependent on others, they will seek to satisfy their ego. The ultimate aim of the human ego is to be something, which if they have failed to achieve, they will go down a spiral of negative emotions and gloom. Nurses with an understanding of the psychology and ego integrity are responsible for lifting up the elderly from going down that spiral and hurting themselves.
REFERENCES
1. Jare Easter Brook, (2002) “Elderly Care”, 4th edition:Macmillan publishers.
2. “Senior Citizens – status in India”, Ministry of Electronics and Information Technology[Last accessed on 2017 Feb 16]. Available from: http://vikaspedia.in/social-welfare/senior-citizens-welfare/senior-citizens-status-in-india
3. Ramesh Verma and Pardeep Khanna, “National Program of Health-Care for the Elderly in India: A Hope for Healthy Ageing”; International Journal of Preventive Medicine. Volume 4, Issue 10, October 2013;Pp 1103–1107.
4. National Sample Survey Organization, Ministry of Statistics and Programme Implementation, Government of India; Central Statistics Office. New Delhi: 2006.
5. Frederic P Miller, Agnes F Vandome, John McBrewster(2011) “Ego Integrity”, International Book Marketing Service Limited Publishers
Received on 30.03.2017 Modified on 12.12.2017
Accepted on 11.01.2018 © A&V Publications all right reserved
Int. J. Nur. Edu. and Research. 2018; 6(1): 78-80.
DOI: 10.5958/2454-2660.2018.00019.4